Qusayy M Godbolt, PH.D, BCBA-D

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-09-5273

Practice address

1207 Snowball LN
Clarksville, TN 37042-7855

Phone

(931) 378-4751

NPI assigned

Mar 24, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Qusayy M. Godbolt

  • Behavior Analyst
  • Clarksville, TN
  • NPI 1497303960
  NPD
• Capable Beginnings, LLC

  • Speech-Language Pathologist
  • Clarksville, TN
  • NPI 1952851032
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1269388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1740504398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 SNOWBALL LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427855",
            "telephone_number": "931-378-4751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 SNOWBALL LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370427855",
            "telephone_number": "931-378-4751"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1273 Northfield Dr Ste 3",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370406184",
            "country_code": "US",
            "telephone_number": "931-553-3942",
            "fax_number": "931-443-0423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GODBOLT",
        "first_name": "QUSAYY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PH.D, BCBA-D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-24",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "KY",
            "license": "1-09-5273",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "TN",
            "license": "1-09-5273",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "1-09-5273",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "FL",
            "license": "1-09-5273",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "1-09-5273",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q024708",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100405480",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alison Leigh Goad, L.C.S.W.
• Goals of Care, PLLC
• Nick Goard
• Michelle Ley Gobbell, DPT
• Lisa M Goble, RN
• Denise Goin, LCSW
• Katrina Goins
• Jacey Golden
• Anna W. Goletz
• Jessica M Golson

• Behavior Analyst in Clarksville, TN
• Providers in Clarksville, TN by specialty
• Behavior Analyst in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.